Abstract
Purpose: To compare visual acuity and contrast sensitivity between Posterior Chamber Phakic Intraocular Lens (ICL) and Iris-Claw Anterior Chamber Phakic Intraocular Lens (Artiflex) implantation for moderate to high myopia. Setting: Dr. Lutfi Kirdar Kartal Training and Research Hospital, Eye Clinic, Istanbul, Turkey. Participants: Sixty eyes of 30 myopic patients were included in the study. Thirty eyes of 15 patients underwent implantation of ICL (24)/ toric ICL (6) and 30 eyes of 15 patients underwent implantation of Artiflex. Methods: Preoperative and postoperative 1, 6 and 12 months, logarithm of the minimum angle of resolution (log MAR) uncorrected visual acuity (UCVA), log MAR best spectacle-corrected visual acuity (BSCVA), manifest refraction, intraocular pressure (IOP), endothelial cell density (ECD) and complications were evaluated. Contrast sensitivity (CS) was also evaluated at 1.5, 2.52, 4.23, 7.10 and 11.91 cycles per degree spatial frequencies by CC-100 Topcon LCD preoperative and postoperative 1-year. Main outcome measures: Improvement in visual acuity (VA) and CS, percentage change in ECD and IOP. Results: Preoperatively, there was no significant difference in the mean UCVA, BSCVA and CS between the ICL and Artiflex groups (p=0.798; 0.672; 0.510) and the mean spherical equivalent (SE) was significantly better in the ICL group than the Artiflex group (p=0.003). One year postoperatively, the mean UCVA and BSCVA were significantly better in the ICL group than the Artiflex group (p=0.002; 0.0001). We found no significant difference in the mean SE between the ICL and Artiflex groups (p=0.809). The mean photopic CS increased considerably at all spatial frequencies compared with preoperative levels in the ICL and Artiflex groups (p=0.0001) Conclusion: After 1-year follow-up, the phakic IOLs performed well in correcting moderate to high myopia. Preoperatively and 1-year postoperatively, there was no significant difference in the mean photopic CS between the ICL and Artiflex group at all spatial frequencies. No vision-threatening complications occurred during the observation period.
Highlights
Implantation of phakic intraocular lenses is a recent alternative for high refractive errors management in patients who are not candidates for refractive lens exchange or corneal refractive procedures [1,2]
Preoperatively, there was no significant difference in the mean uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA) and CS between the Intraocular Lens (ICL) and Artiflex groups (p=0.798; 0.672; 0.510) and the mean spherical equivalent (SE) was significantly better in the ICL group than the Artiflex group (p=0.003)
The mean UCVA and BSCVA were significantly better in the ICL group than the Artiflex group (p=0.002; 0.0001)
Summary
Implantation of phakic intraocular lenses (pIOLs) is a recent alternative for high refractive errors management in patients who are not candidates for refractive lens exchange or corneal refractive procedures [1,2]. For correction of high myopia, these methods have higher corneal complications rate than pIOL [3]. Corneal refractive procedures induce optical aberrations than pIOL for the correction myopia [4]. For treatment of moderate and high myopia, pIOL implantation provides a better visual outcome than keratorefractive procedures[4]. The pIOL is removable and has potential to be reversible, whereas with keratorefractive surgery, this cannot be done even when unexpected results happen after surgery [5]
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